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Author
Topic: Any idea as to what this could be? (Read 4561 times)

Hi everyone! I know I haven't been around much, just busy with life and work, etc. I was so saddened and sorry to hear about the passing of so many folks here of late. So sad... my heart is with them and each of you!

I have a question for you... does anyone have a clue as to what this could be? I just hope the image comes through... took me a while & Ann's help to figure it out. Providing I did this right.

It started about 2 or 3 months ago and gradually grew to what you see here. It's itchy, mostly at night. I don't recall being bitten by any insects. I've been taking Hydroxyzine to help the itch. There had been some swelling at some point, but that has subsided over the past couple of weeks. My ID doc hasn't got a clue what the hell it is. At first she thought it was psoriasis, then a fungal infecion. We've tried some creams: triamcinolone acetonide; clortrimazole, but they haven't worked at all. Neosporin did help a bit, but the rash is not going away & I still experience itching at night mostly. Sometimes there are pustules, and then turn into dry patches of skin that flake off. I have finally been able to secure an appointment with a dermatologist after 2/3 months of waiting for the clinic to get back to me, which they never did... I had to go elsewhere. One thing I've learned, always need to advocate for ourselves especially when it's time to find a doctor.

BTW, my HIV is well in check... cd4's @ 1500, vl is undetectable. No problems there, just all that getting older crap that's creeping up.

Anyway, I'd appreciate any thoughts on my ugly ankle.

I wish you all the best... thanks again!

Trish

Edited to add the image!!

« Last Edit: July 13, 2010, 01:16:13 PM by Trish »

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"People grow through experience if they meet life honestly and courageously. This is how character is buit." Eleanor Roosevelt

Glad you got the appointment with the dermatologist. I really have no clue what it would be. My only thought is given how it seems to stop just above the ankle, maybe it could be contact dermatitis???Do you wear socks that only go up to this point? I had contact derm at one time and it was from my t-shirts --- didn't affect my arms, was just chest and back - no other area of the body. I switched to one of the clear detergents (after seeing a dermatologist) - with no allergens/perfumes - and it went away. After awhile I was able to go back to regular detergent.

Thanks phildinftlaudy! The doc ruled out contact dermatitis.. I've been using the same detergent for years (Tide) and don't have any rashes anywhere else on my body. I would assume I would have a reaction elsewhere, but there isn't any. However, after you suggested you only had it on your chest and no where else, perhaps it could be just that. I do appreciate your thoughts. Unfortunately, I won't see the dermatologist until August 17th. Ahhhh, waiting, waiting, waiting... a person could die in that time.

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"People grow through experience if they meet life honestly and courageously. This is how character is buit." Eleanor Roosevelt

Thanks phildinftlaudy! The doc ruled out contact dermatitis.. I've been using the same detergent for years (Tide) and don't have any rashes anywhere else on my body. I would assume I would have a reaction elsewhere, but there isn't any. However, after you suggested you only had it on your chest and no where else, perhaps it could be just that. I do appreciate your thoughts. Unfortunately, I won't see the dermatologist until August 17th. Ahhhh, waiting, waiting, waiting... a person could die in that time.

Hi Trish - When I got the contact dermatitis, I had also been using the same detergent for years and it just came on. It was weird because I didn't get it on any other part of my body (i.e. feet, legs, etc) in spite of clothing touching those areas that had been washed in same detergent. You may want to try changing detergent to something like All Free and Clear and see if it clears up --- unless it is related to some type of footwear (i.e. material in a shoe that you are wearing). I'm such a baby I probably would have went to the urgent care walk in center rather then wait til mid-August for an appointment. Hope you figure out what it is.

Thanks phildinftlaudy! The doc ruled out contact dermatitis.. I've been using the same detergent for years (Tide) and don't have any rashes anywhere else on my body. I would assume I would have a reaction elsewhere, but there isn't any. However, after you suggested you only had it on your chest and no where else, perhaps it could be just that. I do appreciate your thoughts. Unfortunately, I won't see the dermatologist until August 17th. Ahhhh, waiting, waiting, waiting... a person could die in that time.

Hey Trish, longtime no see. Sorry about the issues you're having with that ankle there, it looks painful. I just wanted to add something to what Phil said- Tide is one of the worst offenders, especially for those of us that live in hot humid places. I can't use it at all and this dates back to my teenage years. I've heard from some people who suddenly have to quit using it after years of having no problems with it. While your doc's probably right, I would definitely still bring it up with the dermatologist in August.

As you noted, it's been a little rough around here lately, so it's good to see an old face pop-in.

Trish, it looks like Tinea (Ringworm) to me - I say this because I've had it, only further up the leg (hey, I grew up on a farm and my mother's motto to us playing in the dirt was "they'll build a strong immune system", she obviously never figure on HIV coming along but that's another story!)

The fungal infection tends to start somewhere warm and damp (as in the case of socked feet and ankles) causing intense itching at night.

You don't say how long you tried the clotrimazole for - it took me 4-5 weeks to shift a slightly smaller patch. Also, do you have pets? This type of fungal infection is zoonotic as it moves between humans and animals - especially cats or small dogs running around your feet. Here's a similar pic of Ringworm on an ankle (hope this works):

I know you've tried the clotrimazole but not sure for how long - it really is a wash the area and apply twice a day treatment for up to six weeks and you won't notice it working for a while. I also found atarax helped with the itch. As I say, mine was cleared in four weeks with twice daily washing of the area and application of the clotrimazole (that can end up being a few tubes!) but its a stubborn thing to shift.

I would hate to wait until the middle of August, too. Could you email the pix to a derm doc? I know many docs have their own websites today and ways to contact them via email. Maybe request the doc you have appt with look a pix now to make sure nothing serious until you can see him/her in person. I hope it gets better.

Hi Trish...It is great to see you posting again, you're such a great contributor here over the years. But I'm so sorry to see you with such a skin problem. You've gotten sage advice here, including the possibility of the socks, maybe an allergy to the material, seeing as there is a line where a sock would end. I'm saddened a dermatologist could not squeeze you in as a first or last appointment, perhaps even the hospital emergency room if that is an option and the condition worsens....Here is to a good healing process for you and better days ahead. Best to John.

Jody

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It started about 2 or 3 months ago and gradually grew to what you see here. It's itchy, mostly at night. I don't recall being bitten by any insects. I've been taking Hydroxyzine to help the itch. There had been some swelling at some point, but that has subsided over the past couple of weeks. My ID doc hasn't got a clue what the hell it is. At first she thought it was psoriasis, then a fungal infecion. We've tried some creams: triamcinolone acetonide; clortrimazole, but they haven't worked at all. Neosporin did help a bit, but the rash is not going away & I still experience itching at night mostly. Sometimes there are pustules, and then turn into dry patches of skin that flake off. I have finally been able to secure an appointment with a dermatologist after 2/3 months of waiting for the clinic to get back to me, which they never did... I had to go elsewhere. One thing I've learned, always need to advocate for ourselves especially when it's time to find a doctor.

BTW, my HIV is well in check... cd4's @ 1500, vl is undetectable. No problems there, just all that getting older crap that's creeping up.

Hi Trish,

Does the rash appear on the sole of your foot? If not it could be urticaria (hives) and might respond to over the counter antihistamine tablets.

There are lots of potential causes including sudden exposure to extreme heat or cold - has anything like this happened to your foot lately?

Has your doctor taken swabs?

hope it clears up soon

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i'm going with realist's train of thought...the potential for ringworm. you have unilateral effect that was smaller and grew. it's itchy and scaley. clotrimazole is an effective antifungal, but sometimes ringworm can be very stubborn. additionally, the use of triamcinolone (a potent corticosteroid) while temporarily reducing the itch worsens the fungal disease, if in fact ringworm is the offender. your regular doc should be able to do a plain old fungal culture to rule out ringworm. after that is done and during the interim, ketoconazole 2% would likely be a better topical med choice every 12 hours x 3-6 weeks. maybe run that by your doc...

Hi Real... thanks so much!! My foot actually looked exactly like the pic you posted. Exactly like it!!! And crazy thing is, I mentioned this to my doc, but she didn't agree with me cause the clortrimazole didn't seem to be working, but maybe I should have stuck with it longer. I used it for about 6 weeks. I suppose it is/was a stubborn infection that I have/had (it is going away, slowly though without treatment now.)

Anyway, she switched me to the triamcinolone thinking it was psoriasis or contact derm or something like that. It's also crazy that you mention that the Tinea can be passed from humans to animals... we have a beagle, and lately he has been scratching at the back of his ear & neck, making it bleed. We've washed the spot he's been scratching and didn't see anything at first, but now I see a bit of a rash. We'll be taking him to the vet. Funny, we can get him in for an appt, but I gotta wait. LMAO Hmmm, very interesting. Ya know, I even mentioned to the doc that maybe this is something I picked up from the dog. She disagreed, again. Boomer, our dog, always sleeps at my feet, but I only have the infection on one foot. She said, "you'd probably have it on both if it was from the dog." Oh boy, I can't wait to go back to tell her this... thanks for the insight!!!

Tom, yes, it's been a long time. I hope you are doing well, and the family too!!

Jody, I hope life is treating you well. It's been a very long time since we've communicated. Thanks for being such a good friend. I've just been busy with life, work, advoacy and getting ready for culinary school in January.

Max, Ted & Phil.... thanks for the input. Although I don't you all very well, I do hope you enjoy yourselves here at AM, there are some great folks with so much knowledge and compassion.

Really, thanks to each of you. I knew I'd get some real concrete answers here. :-) Now I'm gonna call my doc and fill her in. BTW, I'm in the market for a new HIV doc... the clinic simply isn't cutting it for me, especially with all the little shit I've been dealing with.

Best to you all!!!

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"People grow through experience if they meet life honestly and courageously. This is how character is buit." Eleanor Roosevelt

I'll second what realist has said. I had it for years, to be honest, antifungal's helped to an extent but never entirely cleared it up and it would come back. Nothing the doctor gave me ever worked.

It could be that you have a candida overgrowth in your intestinal track (candidiasis) which can manifest itself in many ways - one of which is athletes foot (or tinea) that is stubborn and keeps coming back. This is just one of a plethora of websites on it http://www.thecandidadiet.com/candidasymptoms.htm. It's not an uncommon thing for peopole with compromised immune systems.

I cut down my yeast and sugar intakes and took a probiotic for about 3 months (inner health plus, brand, which i take a 30 day course of every now and then) to help restore the proper balance in my gut flora. After putting up with it for years it has cleared up. Oh, I've also given up smoking which has helped my circulation into my feet. One or the other seems to have worked. touch wood.

I knew a bartender many years ago who had a similar rash on both of his hands. He said it was Candida and was caused by the chemicals used in washing bar glasses. His rash went away when he started wearing gloves to handle the glassware. It is plain ass ridiculous you have to wait weeks for a referral to see a Dermatologist Have the best dayMichael

Mark & Michael... so good to see you. Thanks for the responses. All of you have been very helpful. Well, here's the deal... my rash has improved significantly, almost gone. The dog's rash has cleared up as well. I'm supposed to see the derm on Aug. 10, but by that time I really believe it will be completely gone. Figures!!! Not sure I'll even keep the appt. as I really cannot afford it. I do have Medicare/Medicaid, but they only accept Medicare. I would be responsible for 20% of the bill and I'm certain it will be more than I can cover.

I truly appreciate all of your responses! :-)

Wishing you all the best!!!Trish

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"People grow through experience if they meet life honestly and courageously. This is how character is buit." Eleanor Roosevelt

Great news. Remember it can flare back up (assuming it was tinea/ringworm) - particularly spring/summer time when its warm. As soon as you feel it coming back jump all over it with some clotrimazole - its a bit like a cold sore in this regard, as soon as you feel the tingle you know its time to slap on some cream and it will be kept at bay.